Organization
LACONIA NURSING HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LUBA SERVIL (OFFICE MANAGER)
(718) 654-5875
Entity
Organization
Contact information
Practice address
1050 E 230TH ST, BRONX, NY 10466-4810
(718) 654-5875
(718) 701-5684
Mailing address
1050 E 230TH ST, BRONX, NY 10466-4810
(718) 654-5875
(718) 405-5958
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
7000370N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00311468
—
NY
Enumeration date
10/24/2006
Last updated
10/25/2011
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